Search results for: health services research

Authors: Marielle Leijten, Catherine Meulemans, Sven De Maeyer, Luuk Van Waes

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For the diagnosis of Alzheimer's disease (AD), a large variety of neuropsychological tests are available. In some of these tests, linguistic processing - both oral and written - is an important factor. Language disturbances might serve as a strong indicator for an underlying neurodegenerative disorder like AD. However, the current diagnostic instruments for language assessment mainly focus on product measures, such as text length or number of errors, ignoring the importance of the process that leads to written or spoken language production. In this study, it is our aim to describe and test differences between cognitive and impaired elderly on the basis of a selection of writing process variables (inter- and intrapersonal characteristics). These process variables are mainly related to pause times, because the number, length, and location of pauses have proven to be an important indicator of the cognitive complexity of a process. Method: Participants that were enrolled in our research were chosen on the basis of a number of basic criteria necessary to collect reliable writing process data. Furthermore, we opted to match the thirteen cognitively impaired patients (8 MCI and 5 AD) with thirteen cognitively healthy elderly. At the start of the experiment, participants were each given a number of tests, such as the Mini-Mental State Examination test (MMSE), the Geriatric Depression Scale (GDS), the forward and backward digit span and the Edinburgh Handedness Inventory (EHI). Also, a questionnaire was used to collect socio-demographic information (age, gender, eduction) of the subjects as well as more details on their level of computer literacy. The tests and questionnaire were followed by two typing tasks and two picture description tasks. For the typing tasks participants had to copy (type) characters, words and sentences from a screen, whereas the picture description tasks each consisted of an image they had to describe in a few sentences. Both the typing and the picture description tasks were logged with Inputlog, a keystroke logging tool that allows us to log and time stamp keystroke activity to reconstruct and describe text production processes. The main rationale behind keystroke logging is that writing fluency and flow reveal traces of the underlying cognitive processes. This explains the analytical focus on pause (length, number, distribution, location, etc.) and revision (number, type, operation, embeddedness, location, etc.) characteristics. As in speech, pause times are seen as indexical of cognitive effort. Results. Preliminary analysis already showed some promising results concerning pause times before, within and after words. For all variables, mixed effects models were used that included participants as a random effect and MMSE scores, GDS scores and word categories (such as determiners and nouns) as a fixed effect. For pause times before and after words cognitively impaired patients paused longer than healthy elderly. These variables did not show an interaction effect between the group participants (cognitively impaired or healthy elderly) belonged to and word categories. However, pause times within words did show an interaction effect, which indicates pause times within certain word categories differ significantly between patients and healthy elderly.

Keywords: Alzheimer's disease, keystroke logging, matching, writing process

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Authors: Sweta Rout-Hoolash

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Each year, selected students from around 20 countries begin their degrees at Middlesex University with the International Foundation Program (IFP), developing the skills required for academic study at a UK university. The IFP runs for 30 learning/teaching weeks at Middlesex University Mauritius Branch Campus, which is an international campus of UK’s Middlesex University. Successful IFP students join their degree courses already settled into life at their chosen campus (London, Dubai, Mauritius or Malta) and confident that they understand what is required for degree study. Although part of the School of Science and Technology, in Mauritius it prepares students for undergraduate level across all Schools represented on campus – including disciplines such as Accounting, Business, Computing, Law, Media and Psychology. The researcher has critically reviewed the framework and resources in the curriculum for a particular six week period of IFP study (dedicated group work phase). Despite working together closely for 24 weeks, IFP students approach the final 6 week small group work project phase with mainly inhibitive feelings. It was observed that students did not engage effectively in the group work exercise. Additionally, groups who seemed to be working well did not necessarily produce results reflecting effective collaboration, nor individual members’ results which were better than prior efforts. The researcher identified scope for change and innovation in the IFP curriculum and how group work is introduced and facilitated. The study explores the challenges of groupwork in the context of the Mauritius campus, though it is clear that the implications of the project are not restricted to one campus only. The presentation offers a reflective review on the previous structure put in place for the management of small group assessed projects on the programme from both the student and tutor perspective. The focus of the research perspective is the student voice, by taking into consideration past and present IFP students’ experiences as written in their learning journals. Further, it proposes the introduction of a revised framework to help students take greater ownership of the group work process in order to engage more effectively with the learning outcomes of this crucial phase of the programme. The study has critically reviewed recent and seminal literature on how to achieve greater student ownership during this phase especially under an environment of assessed multicultural group work. The presentation proposes several new approaches for encouraging students to take more control of the collaboration process. Detailed consideration is given to how the proposed changes impact on the work of other stakeholders, or partners to student learning. Clear proposals are laid out for evaluation of the different approaches intended to be implemented during the upcoming academic year (student voice through their own submitted reflections, focus group interviews and through the assessment results). The proposals presented are all realistic and have the potential to transform students’ learning. Furthermore, the study has engaged with the UK Professional Standards Framework for teaching and supporting learning in higher education, and demonstrates practice at the level of ‘fellow’ of the Higher Education Academy (HEA).

Keywords: collaborative peer learning, enhancing learning experiences, group work assessment, learning communities, multicultural diverse classrooms, studying abroad

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Authors: Chris Fersterer, Col Fay, Tobias Danielmeier, Kat Achterberg, Scott Willis

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New Zealand, an island nation, has an extensive coastline peppered with small communities of iconic buildings known as Bachs. Post WWII, these modest buildings were constructed by their owners as retreats and generally were small, low cost, often using recycled material and often they fell below current acceptable building standards. In the latter part of the 20^th century, real estate prices in many of these communities remained low and these areas became permanent residences for people attracted to this affordable lifestyle choice. The Blueskin Resilient Communities Trust (BRCT) is an organisation that recognises the vulnerability of communities in low lying settlements as now being prone to increased flood threat brought about by climate change and sea level rise. Some of the inhabitants of Blueskin Bay, Otago, NZ have already found their properties to be un-insurable because of increased frequency of flood events and property values have slumped accordingly. Territorial authorities also acknowledge this increased risk and have created additional compliance measures for new buildings that are less than 2 m above tidal peaks. Community resilience becomes an additional concern where inhabitants are attracted to a lifestyle associated with a specific location and its people when this lifestyle is unable to be met in a suburban or city context. Traditional models of social housing fail to provide the sense of community connectedness and identity enjoyed by the current residents of Blueskin Bay. BRCT have partnered with the Otago Polytechnic Design School to design a new form of community housing that can react to this environmental change. It is a longitudinal project incorporating participatory approaches as a means of getting people ‘on board’, to understand complex systems and co-develop solutions. In the first period, they are seeking industry support and funding to develop a transportable and fully self-contained housing model that exploits current technologies. BRCT also hope that the building will become an educational tool to highlight climate change issues facing us today. This paper uses the Climate Safe House (CSH) as a case study for education in architectural sustainability through experiential learning offered as part of the Otago Polytechnics Bachelor of Design. Students engage with the project with research methodologies, including site surveys, resident interviews, data sourced from government agencies and physical modelling. The process involves collaboration across design disciplines including product and interior design but also includes connections with industry, both within the education institution and stakeholder industries introduced through BRCT. This project offers a rich learning environment where students become engaged through project based learning within a community of practice, including architecture, construction, energy and other related fields. The design outcomes are expressed in a series of public exhibitions and forums where community input is sought in a truly participatory process.

Keywords: community resilience, problem based learning, project based learning, case study

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Authors: Rawan Hakawati, Beatrice Smyth, David Rooney, Geoffrey McCullough

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Targets have been set in the EU to increase the share of renewable energy consumption to 20% by 2020, but developments have not occurred evenly across the member states. Northern Ireland is almost 90% dependent on imported fossil fuels. With such high energy dependency, Northern Ireland is particularly susceptible to the security of supply issues. Linked to fossil fuels are greenhouse gas emissions, and the EU plans to reduce emissions by 20% by 2020. The use of indigenously produced biomass could reduce both greenhouse gas emissions and external energy dependence. With a wide range of both crop and waste feedstock potentially available in Northern Ireland, anaerobic digestion has been put forward as a possible solution for renewable energy production, waste management, and greenhouse gas reduction. Not all feedstock, however, is the same, and an understanding of feedstock suitability is important for both plant operators and policy makers. The aim of this paper is to investigate biomass suitability for anaerobic digestion in Northern Ireland. It is also important that decisions are based on solid scientific evidence. For this reason, the methodology used is multi-criteria decision matrix analysis which takes multiple criteria into account simultaneously and ranks alternatives accordingly. The model uses the weighted sum method (which follows the Entropy Method to measure uncertainty using probability theory) to decide on weights. The Topsis method is utilized to carry out the mathematical analysis to provide the final scores. Feedstock that is currently available in Northern Ireland was classified into two categories: wastes (manure, sewage sludge and food waste) and energy crops, specifically grass silage. To select the most suitable feedstock, methane yield, feedstock availability, feedstock production cost, biogas production, calorific value, produced kilowatt-hours, dry matter content, and carbon to nitrogen ratio were assessed. The highest weight (0.249) corresponded to production cost reflecting a variation of £41 gate fee to 22£/tonne cost. The weights calculated found that grass silage was the most suitable feedstock. A sensitivity analysis was then conducted to investigate the impact of weights. The analysis used the Pugh Matrix Method which relies upon The Analytical Hierarchy Process and pairwise comparisons to determine a weighting for each criterion. The results showed that the highest weight (0.193) corresponded to biogas production indicating that grass silage and manure are the most suitable feedstock. Introducing co-digestion of two or more substrates can boost the biogas yield due to a synergistic effect induced by the feedstock to favor positive biological interactions. A further benefit of co-digesting manure is that the anaerobic digestion process also acts as a waste management strategy. From the research, it was concluded that energy from agricultural biomass is highly advantageous in Northern Ireland because it would increase the country's production of renewable energy, manage waste production, and would limit the production of greenhouse gases (current contribution from agriculture sector is 26%). Decision-making methods based on scientific evidence aid policy makers in classifying multiple criteria in a logical mathematical manner in order to reach a resolution.

Keywords: anaerobic digestion, biomass as feedstock, decision matrix, renewable energy

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Authors: M. M. Wickramasinghe

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Cholesterol and triglycerides are lipids, mainly essential to maintain the cellular structure of the human body. Cholesterol is also important for hormone production, vitamin D production, proper digestion functions, and strengthening the immune system. Excess fats in the blood circulation, known as hyperlipidemia, become harmful leading to arterial clogging and causing atherosclerosis. Aim of this research is to develop a treatment protocol to efficiently break down and maintain circulatory lipids by improving blood circulation without strenuous physical exercises while immersed in a tub of water. To achieve the target of strong exercise effect, this method involves generating powerful ozone bubbles to spin, collide, and burst in the water. Powerful emission of air into water is capable of transferring locked energy of the water molecules and releasing energy. This method involves water and air-based impact generated by pumping ozone at the speed of 46 lts/sec with a concentration of 0.03-0.05 ppt according to safety standards of The Federal Institute for Drugs and Medical Devices, BfArM, Germany. The direct impact of ozone bubbles on the muscular system and skin becomes the main target and is capable of increasing the heart rate while immersed in water. A total time duration of 20 minutes is adequate to exert a strong exercise effect, improve blood circulation, and stimulate the nervous and endocrine systems. Unstable ozone breakdown into oxygen release onto the surface of the water giving additional benefits and supplying high-quality air rich in oxygen required to maintain efficient metabolic functions. The breathing technique was introduced to improve the efficiency of lung functions and benefit the air exchange mechanism. The temperature of the water is maintained at 39c to 40c to support arterial dilation and enzyme functions and efficiently improve blood circulation to the vital organs. The buoyancy of water and natural hydrostatic pressure release the tension of the body weight and relax the mind and body. Sufficient hydration (3lts of water per day) is an essential requirement to transport nutrients and remove waste byproducts to process through the liver, kidney, and skin. Proper nutritional intake is an added advantage to optimize the efficiency of this method which aids in a fast recovery process. Within 20-30 days of daily treatment, triglycerides, low-density lipoproteins (LDL), and total cholesterol reduction were observed in patients with abnormal levels of lipid profile. Borderline patients were cleared within 10–15 days of treatment. This is a highly efficient system that provides many benefits and is able to achieve a successful reduction of triglycerides, LDL, and total cholesterol within a short period of time. Supported by proper hydration and nutritional balance, this system of natural treatment maintains healthy levels of lipids in the blood and avoids the risk of cerebral stroke, high blood pressure, and heart attacks.

Keywords: atherosclerosis, cholesterol, hydrotherapy, hyperlipidemia, lipid management, ozone therapy, triglycerides

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Authors: Parth Gupta, Ujjawal Singh, Shashank Kumar, Mansi Chandra, Arnab Sarkar

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Microfluidic devices have emerged as indispensable tools across various scientific disciplines, offering precise control and manipulation of fluids at the microscale. Their efficacy in flow-based research, spanning engineering, chemistry, and biology, relies heavily on the geometric design of microfluidic channels. This work introduces a novel approach to optimise these channels through Response Surface Methodology (RSM), departing from the conventional practice of addressing one parameter at a time. Traditionally, optimising microfluidic channels involved isolated adjustments to individual parameters, limiting the comprehensive understanding of their combined effects. In contrast, our approach considers the simultaneous impact of multiple parameters, employing RSM to efficiently explore the complex design space. The outcome is an innovative microfluidic channel that consumes an optimal sample volume and minimises flow time, enhancing overall efficiency. The relevance of geometric parameter optimization in microfluidic channels extends significantly in biomedical engineering. The flow characteristics of porous materials within these channels depend on many factors, including fluid viscosity, environmental conditions (such as temperature and humidity), and specific design parameters like sample volume, channel width, channel length, and substrate porosity. This intricate interplay directly influences the performance and efficacy of microfluidic devices, which, if not optimized, can lead to increased costs and errors in disease testing and analysis. In the context of biomedical applications, the proposed approach addresses the critical need for precision in fluid flow. it mitigate manufacturing costs associated with trial-and-error methodologies by optimising multiple geometric parameters concurrently. The resulting microfluidic channels offer enhanced performance and contribute to a streamlined, cost-effective process for testing and analyzing diseases. A key highlight of our methodology is its consideration of the interconnected nature of geometric parameters. For instance, the volume of the sample, when optimized alongside channel width, length, and substrate porosity, creates a synergistic effect that minimizes errors and maximizes efficiency. This holistic optimization approach ensures that microfluidic devices operate at their peak performance, delivering reliable results in disease testing. A key highlight of our methodology is its consideration of the interconnected nature of geometric parameters. For instance, the volume of the sample, when optimized alongside channel width, length, and substrate porosity, creates a synergistic effect that minimizes errors and maximizes efficiency. This holistic optimization approach ensures that microfluidic devices operate at their peak performance, delivering reliable results in disease testing. A key highlight of our methodology is its consideration of the interconnected nature of geometric parameters. For instance, the volume of the sample, when optimized alongside channel width, length, and substrate porosity, creates a synergistic effect that minimizes errors and maximizes efficiency. This holistic optimization approach ensures that microfluidic devices operate at their peak performance, delivering reliable results in disease testing.

Keywords: microfluidic device, minitab, statistical optimization, response surface methodology

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Authors: Emilie Gout, Mathias Monnot, Olivier Boutin, Pierre Vanloot, Philippe Moulin

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Water is a precious resource. Treating industrial wastewater remains a considerable technical challenge of our century. The effluent considered for this study is landfill leachate treated by reverse osmosis (RO). Nowadays, in most developed countries, sanitary landfilling is the main method to deal with municipal solid waste. Rainwater percolates through solid waste, generating leachates mostly comprised of organic and inorganic matter. Whilst leachate ages, its composition varies, becoming more and more bio-refractory. RO is already used for landfill leachates as it generates good quality permeate. However, its mains drawback is the production of highly polluted concentrates that cannot be discharged in the environment or reused, which is an important industrial issue. It is against this background that the study of coupling RO with wet air oxidation (WAO) was set to intensify and optimize processes to meet current regulations for water discharge in the environment. WAO is widely studied for effluents containing bio-refractory compounds. Oxidation consists of a destruction reaction capable of mineralizing the recalcitrant organic fraction of pollution into carbon dioxide and water when complete. WAO process in subcritical conditions requires a high-energy consumption, but it can be autothermic in a certain range of chemical oxygen demand (COD) concentrations (10-100 g.L⁻¹). Appropriate COD concentrations are reached in landfill leachate RO concentrates. Therefore, the purpose of this work is to report the performances of mineralization during WAO on RO concentrates. The coupling of RO/WAO has shown promising results in previous works on both synthetic and real effluents in terms of organic carbon (TOC) reduction by WAO and retention by RO. Non-catalytic WAO with air as oxidizer was performed in a lab-scale stirred autoclave (1 L) on landfill leachates RO concentrates collected in different seasons in a sanitary landfill in southern France. The yield of WAO depends on operating parameters such as total pressure, temperature, and time. Compositions of the effluent are also important aspects for process intensification. An experimental design methodology was used to minimize the number of experiments whilst finding the operating conditions achieving the best pollution reduction. The simulation led to a set of 18 experiments, and the responses to highlight process efficiency are pH, conductivity, turbidity, COD, TOC, and inorganic carbon. A 70% oxygen excess was chosen for all the experiments. First experiments showed that COD and TOC abatements of at least 70% were obtained after 90 min at 300°C and 20 MPa, which attested the possibility to treat RO leachate concentrates with WAO. In order to meet French regulations and validate process intensification with industrial effluents, some continuous experiments in a bubble column are foreseen, and some further analyses will be performed, such as biological oxygen demand and study of gas composition. Meanwhile, other industrial effluents are treated to compare RO-WAO performances. These effluents, coming from pharmaceutical, petrochemical, and tertiary wastewater industries, present different specific pollutants that will provide a better comprehension of the hybrid process and prove the intensification and feasibility of the process at an industrial scale. Acknowledgments: This work has been supported by the French National Research Agency (ANR) for the Project TEMPO under the reference number ANR-19-CE04-0002-01.

Keywords: hybrid process, landfill leachates, process intensification, reverse osmosis, wet air oxidation

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Authors: Chandra Shekhar Prasad, Ludek Pesek Prasad

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In the present day fan blade of aero engine, turboprop propellers, gas turbine or steam turbine low-pressure blades are getting bigger, lighter and thus, become more flexible. Therefore, flutter, forced blade response and vibration related failure of the high aspect ratio blade are of main concern for the designers, thus need to be address properly in order to achieve successful component design. At the preliminary design stage large number of design iteration is need to achieve the utter free safe design. Most of the numerical method used for aeroelastic analysis is based on field-based methods such as finite difference method, finite element method, finite volume method or coupled. These numerical schemes are used to solve the coupled fluid Flow-Structural equation based on full Naiver-Stokes (NS) along with structural mechanics’ equations. These type of schemes provides very accurate results if modeled properly, however, they are computationally very expensive and need large computing recourse along with good personal expertise. Therefore, it is not the first choice for aeroelastic analysis during preliminary design phase. A reduced order aeroelastic model (ROAM) with acceptable accuracy and fast execution is more demanded at this stage. Similar ROAM are being used by other researchers for aeroelastic and force response analysis of turbomachinery. In the present paper new medium fidelity ROAM is successfully developed and implemented in numerical tool to simulated the aeroelastic stability phenomena in turbomachinery and well as flexible wings. In the present, a hybrid flow solver based on 3D viscous-inviscid coupled 3D panel method (PM) and 3d discrete vortex particle method (DVM) is developed, viscous parameters are estimated using boundary layer(BL) approach. This method can simulate flow separation and is a good compromise between accuracy and speed compared to CFD. In the second phase of the research work, the flow solver (PM) will be coupled with ROM non-linear beam element method (BEM) based FEM structural solver (with multibody capabilities) to perform the complete aeroelastic simulation of a steam turbine bladed disk, propellers, fan blades, aircraft wing etc. The partitioned based coupling approach is used for fluid-structure interaction (FSI). The numerical results are compared with experimental data for different test cases and for the blade cascade test case, experimental data is obtained from in-house lab experiments at IT CAS. Furthermore, the results from the new aeroelastic model will be compared with classical CFD-CSD based aeroelastic models. The proposed methodology for the aeroelastic stability analysis of gas turbine or steam turbine blades, or propellers or fan blades will provide researchers and engineers a fast, cost-effective and efficient tool for aeroelastic (classical flutter) analysis for different design at preliminary design stage where large numbers of design iteration are required in short time frame.

Keywords: aeroelasticity, beam element method (BEM), discrete vortex particle method (DVM), classical flutter, fluid-structure interaction (FSI), panel method, reduce order aeroelastic model (ROAM), turbomachinery, viscous-inviscid coupling

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Authors: Adiba Matin, Daniel Cabrera, Javiera Bellolio, Jasmine Stewart, Dana Gerberi (librarian), Nathan Cummins, Fernanda Bellolio

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OBJECTIVES: Artificial intelligence (AI) tools are becoming more prevalent in healthcare settings, particularly for diagnostic and therapeutic recommendations, with an expected surge in the incoming years. The bedside use of this technology for clinicians opens the possibility of disagreements between the recommendations from AI algorithms and clinicians’ judgment. There is a paucity in the literature analyzing nature and possible outcomes of these potential conflicts, particularly related to ethical considerations. The goal of this scoping review is to identify, analyze and classify current themes and potential strategies addressing ethical conflicts originating from the conflict between AI and human recommendations. METHODS: A protocol was written prior to the initiation of the study. Relevant literature was searched by a medical librarian for the terms of artificial intelligence, healthcare and liability, ethics, or conflict. Search was run in 2021 in Ovid Cochrane Central Register of Controlled Trials, Embase, Medline, IEEE Xplore, Scopus, and Web of Science Core Collection. Articles describing the role of AI in healthcare that mentioned conflict between humans and AI were included in the primary search. Two investigators working independently and in duplicate screened titles and abstracts and reviewed full-text of potentially eligible studies. Data was abstracted into tables and reported by themes. We followed methodological guidelines for Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). RESULTS: Of 6846 titles and abstracts, 225 full texts were selected, and 48 articles included in this review. 23 articles were included as original research and review papers. 25 were included as editorials and commentaries with similar themes. There was a lack of consensus in the included articles on who would be held liable for mistakes incurred by following AI recommendations. It appears that there is a dichotomy of the perceived ethical consequences depending on if the negative outcome is a result of a human versus AI conflict or secondary to a deviation from standard of care. Themes identified included transparency versus opacity of recommendations, data bias, liability of outcomes, regulatory framework, and the overall scope of artificial intelligence in healthcare. A relevant issue identified was the concern by clinicians of the “black box” nature of these recommendations and the ability to judge appropriateness of AI guidance. CONCLUSION AI clinical tools are being rapidly developed and adopted, and the use of this technology will create conflicts between AI algorithms and healthcare workers with various outcomes. In turn, these conflicts may have legal, and ethical considerations. There is limited consensus about the focus of ethical and liability for outcomes originated from disagreements. This scoping review identified the importance of framing the problem in terms of conflict between standard of care or not, and informed by the themes of transparency/opacity, data bias, legal liability, absent regulatory frameworks and understanding of the technology. Finally, limited recommendations to mitigate ethical conflicts between AI and humans have been identified. Further work is necessary in this field.

Keywords: ethics, artificial intelligence, emergency medicine, review

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Authors: Melina Kopke, Jelle Van Dijk

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Persons with cognitive disabilities, such as Autism Spectrum Disorder (ASD) are often dependent on some form of professional support. Recent transformations in Dutch healthcare have spurred institutions to apply new, empowering methods and tools to enable their clients to cope (more) independently in daily life. Assistive Technologies (ATs) seem promising as empowering tools. While ATs can, functionally speaking, help people to perform certain activities without human assistance, we hold that, from a design-theoretical perspective, such technologies often fail to empower in a deeper sense. Most technologies serve either to prescribe or to monitor users’ actions, which in some sense objectifies them, rather than strengthening their agency. This paper proposes that theories of embodied interaction could help formulating a design vision in which interactive assistive devices augment, rather than replace, human agency and thereby add to a persons’ empowerment in daily life settings. It aims to close the gap between empowerment theory and the opportunities provided by assistive technologies, by showing how embodiment and empowerment theory can be applied in practice in the design of new, interactive assistive devices. Taking a Research-through-Design approach, we conducted a case study of designing to support independently living people with ASD with structuring daily activities. In three iterations we interlaced design action, active involvement and prototype evaluations with future end-users and healthcare professionals, and theoretical reflection. Our co-design sessions revealed the issue of handling daily activities being multidimensional. Not having the ability to self-manage one’s daily life has immense consequences on one’s self-image, and also has major effects on the relationship with professional caregivers. Over the course of the project relevant theoretical principles of both embodiment and empowerment theory together with user-insights, informed our design decisions. This resulted in a system of wireless light units that users can program as a reminder for tasks, but also to record and reflect on their actions. The iterative process helped to gradually refine and reframe our growing understanding of what it concretely means for a technology to empower a person in daily life. Drawing on the case study insights we propose a set of concrete design principles that together form what we call the embodied empowerment design framework. The framework includes four main principles: Enabling ‘reflection-in-action’; making information ‘publicly available’ in order to enable co-reflection and social coupling; enabling the implementation of shared reflections into an ‘endurable-external feedback loop’ embedded in the persons familiar ’lifeworld’; and nudging situated actions with self-created action-affordances. In essence, the framework aims for the self-development of a suitable routine, or ‘situated practice’, by building on a growing shared insight of what works for the person. The framework, we propose, may serve as a starting point for AT designers to create truly empowering interactive products. In a set of follow-up projects involving the participation of persons with ASD, Intellectual Disabilities, Dementia and Acquired Brain Injury, the framework will be applied, evaluated and further refined.

Keywords: assistive technology, design, embodiment, empowerment

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Authors: Indika Fernando, Jiangang Fei, Roger Stanley, Hossein Enshaei

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Delicate produce such as fresh fruits are increasingly susceptible to physiological damage during the essential post-harvest operations such as transport and handling. Vibration and shock during the distribution are identified factors for produce damage within post-harvest supply chains. Mechanical damages caused during transit may significantly diminish the quality of fresh produce which may also result in a substantial wastage. Bananas are one of the staple fruit crops and the most sold supermarket produce in Australia. It is also the largest horticultural industry in the state of Queensland where 95% of the total production of bananas are cultivated. This results in significantly lengthy interstate supply chains where fruits are exposed to prolonged vibration and shocks. This paper is focused on determining the shock and vibration levels experienced by packaged bananas during transit from the farm gate to the retail market. Tri-axis acceleration data were captured by custom made accelerometer based data loggers which were set to a predetermined sampling rate of 400 Hz. The devices recorded data continuously for 96 Hours in the interstate journey of nearly 3000 Km from the growing fields in far north Queensland to the central distribution centre in Melbourne in Victoria. After the bananas were ripened at the ripening facility in Melbourne, the data loggers were used to capture the transport and handling conditions from the central distribution centre to three retail outlets within the outskirts of Melbourne. The quality of bananas were assessed before and after transport at each location along the supply chain. Time series vibration and shock data were used to determine the frequency and the severity of the transient shocks experienced by the packages. Frequency spectrogram was generated to determine the dominant frequencies within each segment of the post-harvest supply chain. Root Mean Square (RMS) acceleration levels were calculated to characterise the vibration intensity during transport. Data were further analysed by Fast Fourier Transform (FFT) and the Power Spectral Density (PSD) profiles were generated to determine the critical frequency ranges. It revealed the frequency range in which the escalated energy levels were transferred to the packages. It was found that the vertical vibration was the highest and the acceleration levels mostly oscillated between ± 1g during transport. Several shock responses were recorded exceeding this range which were mostly attributed to package handling. These detrimental high impact shocks may eventually lead to mechanical damages in bananas such as impact bruising, compression bruising and neck injuries which affect their freshness and visual quality. It was revealed that the frequency range between 0-5 Hz and 15-20 Hz exert an escalated level of vibration energy to the packaged bananas which may result in abrasion damages such as scuffing, fruit rub and blackened rub. Further research is indicated specially in the identified critical frequency ranges to minimise exposure of fruits to the harmful effects of vibration. Improving the handling conditions and also further study on package failure mechanisms when exposed to transient shock excitation will be crucial to improve the visual quality of bananas within the post-harvest supply chain in Australia.

Keywords: bananas, handling, post-harvest, supply chain, shocks, transport, vibration

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Authors: Neelofar, Khursheed Alam, Jamal Ahmad

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Protein modification in diabetes mellitus may lead to early glycation products (EGPs) or amadori product as well as advanced glycation end products (AGEs). Early glycation involves the reaction of glucose with N-terminal and lysyl side chain amino groups to form Schiff’s base which undergoes rearrangements to form more stable early glycation product known as Amadori product. After Amadori, the reactions become more complicated leading to the formation of advanced glycation end products (AGEs) that interact with various AGE receptors, thereby playing an important role in the long-term complications of diabetes. Millard reaction or nonenzymatic glycation reaction accelerate in diabetes due to hyperglycation and alter serum protein’s structure, their normal functions that lead micro and macro vascular complications in diabetic patients. In this study, Human Serum Albumin (HSA) with a constant concentration was incubated with different concentrations of glucose at 370C for a week. At 4th day, Amadori product was formed that was confirmed by colorimetric method NBT assay and TBA assay which both are authenticate early glycation product. Conformational changes in native as well as all samples of Amadori albumin with different concentrations of glucose were investigated by various biophysical and biochemical techniques. Main biophysical techniques hyperchromacity, quenching of fluorescence intensity, FTIR, CD and SDS-PAGE were used. Further conformational changes were observed by biochemical assays mainly HMF formation, fructoseamine, reduction of fructoseamine with NaBH4, carbonyl content estimation, lysine and arginine residues estimation, ANS binding property and thiol group estimation. This study find structural and biochemical changes in Amadori modified HSA with normal to hyperchronic range of glucose with respect to native HSA. When glucose concentration was increased from normal to chronic range biochemical and structural changes also increased. Highest alteration in secondary and tertiary structure and conformation in glycated HSA was observed at the hyperchronic concentration (75mM) of glucose. Although it has been found that Amadori modified proteins is also involved in secondary complications of diabetes as AGEs but very few studies have been done to analyze the conformational changes in Amadori modified proteins due to early glycation. Most of the studies were found on the structural changes in Amadori protein at a particular glucose concentration but no study was found to compare the biophysical and biochemical changes in HSA due to early glycation with a range of glucose concentration at a constant incubation time. So this study provide the information about the biochemical and biophysical changes occur in Amadori modified albumin at a range of glucose normal to chronic in diabetes. Although many implicates currently in use i.e. glycaemic control, insulin treatment and other chemical therapies that can control many aspects of diabetes. However, even with intensive use of current antidiabetic agents more than 50 % of diabetic patient’s type 2 suffers poor glycaemic control and 18 % develop serious complications within six years of diagnosis. Experimental evidence related to diabetes suggests that preventing the nonenzymatic glycation of relevant proteins or blocking their biological effects might beneficially influence the evolution of vascular complications in diabetic patients or quantization of amadori adduct of HSA by authentic antibodies against HSA-EGPs can be used as marker for early detection of the initiation/progression of secondary complications of diabetes. So this research work may be helpful for the same.

Keywords: diabetes mellitus, glycation, albumin, amadori, biophysical and biochemical techniques

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Authors: Iryna P. Dzieciuch, Michael D. Putman

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Humidity is known to degrade Navy ship electronic equipment, especially in hot moist environments. If left untreated, it can cause significant and permanent damage. Even rigorous inspection and frequent clean-up would not prevent further equipment contamination and degradation because of the constant presence of favorable growth conditions for many microorganisms. Generally, relative humidity levels of less than 60% will inhibit corrosion in electronic equipment, but because NAVY electronics often operate in hot and humid environments, prevention via dehumidification is not always possible. Currently, there is no defined research that fully describes key mechanisms which cause electronics and its coating degradation. The corrosive action of most bacteria is mainly developed through (i) mycelium adherence to the metal plates, (ii) facilitation the formation of pitting areas, (iii) production of organic acids such as citric, iso-citric, cis-aconitic, alpha-ketoglutaric, which are corrosive to electronic equipment and its components. Our approach studies corrosive action in electronic equipment: circuit-board, wires and connections that are exposed in the humid environment that gets worse during condensation. In our new approach the technical task is built on work with the bacterial communities in public areas, bacterial genetics, bioinformatics, biostatistics and Scanning Electron Microscopy (SEM) of corroded circuit boards. Based on these methods, we collect and examine environmental samples from biofilms of the corroded and non-corroded sites, where bacterial contamination of electronic equipment, such as machine racks and shore boats, is an ongoing concern. Sample collection and sample analysis is focused on addressing the key questions identified above through the following tasks: laboratory sample processing and evaluation under scanning electron microscopy, initial sequencing and data evaluation; bioinformatics and data analysis. Preliminary results from scanning electron microscopy (SEM) have revealed that metal particulates and alloys in corroded samples consists mostly of Tin ( < 40%), Silicon ( < 4%), Sulfur ( < 1%), Aluminum ( < 2%), Magnesium ( < 2%), Copper ( < 1%), Bromine ( < 2%), Barium ( <1%) and Iron ( < 2%) elements. We have also performed X 12000 magnification of the same sites and that proved existence of undisrupted biofilm organelles and crystal structures. Non-corrosion sites have revealed high presence of copper ( < 47%); other metals remain at the comparable level as on the samples with corrosion. We have performed X 1000 magnification on the non-corroded at the sites and have documented formation of copper crystals. The next step of this study, is to perform metagenomics sequencing at all sites and to compare bacterial composition present in the environment. While copper is nontoxic to the living organisms, the process of bacterial adhesion creates acidic environment by releasing citric, iso-citric, cis-aconitic, alpha-ketoglutaric acidics, which in turn release copper ions Cu++, which that are highly toxic to the bacteria and higher order living organisms. This phenomenon, might explain natural “antibiotic” properties that are lacking in elements such as tin. To prove or deny this hypothesis we will use next - generation sequencing (NGS) methods to investigate types and growth cycles of bacteria that from bacterial biofilm the on corrosive and non-corrosive samples.

Keywords: bacteria, biofilm, circuit board, copper, corrosion, electronic equipment, organic acids, tin

Procedia PDF Downloads 136

Authors: Justine Salam

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As a federal state, Canada’s constitutional arrangements regarding the management of natural resources is unique because it gives complete ownership and control of natural resources to the provinces (subnational level). However, the province of Alberta—home to the third largest oil reserves in the world—lags behind comparable jurisdictions in levying royalties on oil corporations, especially oil sands royalties. While Albertans own the oil sands, scholars have argued that natural resource exploitation in Alberta benefits corporations and industry more than it does Albertans. This study provides a systematic understanding of the causal factors affecting royalties in Alberta to map dynamics of power and how they manifest themselves during policy-making. Mounting domestic and global public pressure led Alberta to review its oil sands royalties twice in less than a decade through public-commissioned Royalty Review Panels, first in 2007 and again in 2015. The Panels’ task was to research best practices and to provide policy recommendations to the Government through public consultations with Albertans, industry, non-governmental organizations, and First Nations peoples. Both times, the Panels recommended a relative increase to oil sands royalties. However, irrespective of the Reviews’ recommendations, neither the right-wing 2007 Progressive Conservative Party (PC) nor the left-wing 2015 New Democratic Party (NDP) government—both committed to increase oil sands royalties—increased royalty intake. Why did two consecutive political parties at opposite ends of the political spectrum fail to account for the recommendations put forward by the Panel? Through a qualitative case-study analysis, this study assesses domestic and global causal factors for Alberta’s inability to raise oil sands royalties significantly after the two Reviews through an institutions, interests, and ideas framework. Indeed, causal factors can be global (e.g. market and price fluctuation) or domestic (e.g. oil companies’ influence on the Alberta government). The institutions, interests, and ideas framework is at the intersection of public policy, comparative studies, and political economy literatures, and therefore draws multi-faceted insights into the analysis. To account for institutions, the study proposes to review international trade agreements documents such as the North American Free Trade Agreement (NAFTA) because they have embedded Alberta’s oil sands into American energy security policy and tied Canadian and Albertan oil policy in legal international nods. To account for interests, such as how the oil lobby or the environment lobby can penetrate governmental decision-making spheres, the study draws on the Oil Sands Oral History project, a database of interviews from government officials and oil industry leaders at a pivotal time in Alberta’s oil industry, 2011-2013. Finally, to account for ideas, such as how narratives of Canada as a global ‘energy superpower’ and the importance of ‘energy security’ have dominated and polarized public discourse, the study relies on content analysis of Alberta-based pro-industry newspapers to trace the prevalence of these narratives. By mapping systematically the nods and dynamics of power at play in Alberta, the study sheds light on the factors that influence royalty policy-making in one of the largest industries in Canada.

Keywords: Alberta Canada, natural resources governance, oil sands, political economy

Procedia PDF Downloads 116

Authors: Kazuhiro Tateda, Elisa Gonzalez, Shuhei Ito, Kirstin Heinrich, Kevin Sweetland, Pingping Zhang, Catia Ferreira, Michael Pride, Jennifer Moisi, Sharon Gray, Bennett Lee, Fred Angulo

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Clostridium difficile (C. difficile) is the most common cause of antibiotic-associated diarrhea and infectious diarrhea in healthcare settings. Japan has an aging population; the elderly are at increased risk of hospitalization, antibiotic use, and C. difficile infection (CDI). Little is known about the population-based incidence and disease burden of CDI in Japan although limited hospital-based studies have reported a lower incidence than the United States. To understand CDI disease burden in Japan, CLOUD (Clostridium difficile Infection Burden of Disease in Adults in Japan) was developed. CLOUD will derive population-based incidence estimates of the number of CDI cases per 100,000 population per year in Ota-ku (population 723,341), one of the districts in Tokyo, Japan. CLOUD will include approximately 14 of the 28 Ota-ku hospitals including Toho University Hospital, which is a 1,000 bed tertiary care teaching hospital. During the 12-month patient enrollment period, which is scheduled to begin in November 2018, Ota-ku residents > 50 years of age who are hospitalized at a participating hospital with diarrhea ( > 3 unformed stools (Bristol Stool Chart 5-7) in 24 hours) will be actively ascertained, consented, and enrolled by study surveillance staff. A stool specimen will be collected from enrolled patients and tested at a local reference laboratory (LSI Medience, Tokyo) using QUIK CHEK COMPLETE® (Abbott Laboratories). which simultaneously tests specimens for the presence of glutamate dehydrogenase (GDH) and C. difficile toxins A and B. A frozen stool specimen will also be sent to the Pfizer Laboratory (Pearl River, United States) for analysis using a two-step diagnostic testing algorithm that is based on detection of C. difficile strains/spores harboring toxin B gene by PCR followed by detection of free toxins (A and B) using a proprietary cell cytotoxicity neutralization assay (CCNA) developed by Pfizer. Positive specimens will be anaerobically cultured, and C. difficile isolates will be characterized by ribotyping and whole genomic sequencing. CDI patients enrolled in CLOUD will be contacted weekly for 90 days following diarrhea onset to describe clinical outcomes including recurrence, reinfection, and mortality, and patient reported economic, clinical and humanistic outcomes (e.g., health-related quality of life, worsening of comorbidities, and patient and caregiver work absenteeism). Studies will also be undertaken to fully characterize the catchment area to enable population-based estimates. The 12-month active ascertainment of CDI cases among hospitalized Ota-ku residents with diarrhea in CLOUD, and the characterization of the Ota-ku catchment area, including estimation of the proportion of all hospitalizations of Ota-ku residents that occur in the CLOUD-participating hospitals, will yield CDI population-based incidence estimates, which can be stratified by age groups, risk groups, and source (hospital-acquired or community-acquired). These incidence estimates will be extrapolated, following age standardization using national census data, to yield CDI disease burden estimates for Japan. CLOUD also serves as a model for studies in other countries that can use the CLOUD protocol to estimate CDI disease burden.

Keywords: Clostridium difficile, disease burden, epidemiology, study protocol

Procedia PDF Downloads 238

Authors: Ana Paula Almeida Castaldelli Maciel, Gabriela Medeiros, Amanda de Souza Machado, Maria Clara Pilatti, Ralpho Rinaldo dos Reis, Silvio Cesar Sampaio

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Sustainable agricultural systems are crucial to ensuring global food security and the long-term production of nutritious food. Comprehensive soil and water management practices, including nutrient management, balanced fertilizer use, and appropriate waste management, are essential for sustainable agriculture. Swine wastewater (SWW) treatment has become a significant focus due to environmental concerns related to heavy metals, antibiotics, resistant pathogens, and nutrients. In South America, small farms use soil to dispose of animal waste, a practice that is expected to increase with global pork production. The potential of SWW as a nutrient source is promising, contributing to global food security, nutrient cycling, and mineral fertilizer reduction. Short- and long-term studies evaluated the effects of SWW on soil and plant parameters, such as nutrients, heavy metals, organic matter (OM), cation exchange capacity (CEC), and pH. Although promising results have been observed in short- and medium-term applications, long-term applications require more attention due to heavy metal concentrations. Organic soil amendment strategies, due to their economic and ecological benefits, are commonly used to reduce the bioavailability of heavy metals. However, the rate of degradation and initial levels of OM must be monitored to avoid changes in soil pH and release of metals. The study aimed to evaluate the long-term effects of SWW application on soil fertility parameters, focusing on calcium (Ca), magnesium (Mg), and potassium (K), in addition to CEC and OM. Experiments were conducted at the Universidade Estadual do Oeste do Paraná, Brazil, using 24 drainage lysimeters for nine years, with different application rates of SWW and mineral fertilization. Principal Component Analysis (PCA) was then conducted to summarize the composite variables, known as principal components (PC), and limit the dimensionality to be evaluated. The retained PCs were then correlated with the original variables to identify the level of association between each variable and each PC. Data were interpreted using Analysis of Variance - ANOVA for general linear models (GLM). As OM was not measured in the 2007 soybean experiment, it was assessed separately from PCA to avoid loss of information. PCA and ANOVA indicated that crop type, SWW, and mineral fertilization significantly influenced soil nutrient levels. Soybeans presented higher concentrations of Ca, Mg, and CEC. The application of SWW influenced K levels, with higher concentrations observed in SWW from biodigesters and higher doses of swine manure. Variability in nutrient concentrations in SWW due to factors such as animal age and feed composition makes standard recommendations challenging. OM levels increased in SWW-treated soils, improving soil fertility and structure. In conclusion, the application of SWW can increase soil fertility and crop productivity, reducing environmental risks. However, careful management and long-term monitoring are essential to optimize benefits and minimize adverse effects.

Keywords: contamination, water research, biodigester, nutrients

Procedia PDF Downloads 31

Authors: Marco Frieslaar, Bing Chu, Eric Rogers

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Stroke is a devastating illness that is the second biggest cause of death in the world (after heart disease). Where it does not kill, it leaves survivors with debilitating sensory and physical impairments that not only seriously harm their quality of life, but also cause a high incidence of severe depression. It is widely accepted that early intervention is essential for recovery, but current rehabilitation techniques largely favor hospital-based therapies which have restricted access, expensive and specialist equipment and tend to side-step the emotional challenges. In addition, there is insufficient funding available to provide the long-term assistance that is required. As a consequence, recovery rates are poor. The relatively unexplored solution is to develop therapies that can be harnessed in the home and are formulated from technologies that already exist in everyday life. This would empower individuals to take control of their own improvement and provide choice in terms of when and where they feel best able to undertake their own healing. This research seeks to identify how effective post-stroke, rehabilitation therapy can be applied to upper limb mobility, within the physical context of a home rather than a hospital. This is being achieved through the design and construction of an automation scheme, based on iterative learning control and the Riener muscle model, that has the ability to adapt to the user and react to their level of fatigue and provide tangible physical recovery. It utilizes a SMART Phone and laptop to construct an iterative learning control (ILC) system, that monitors upper arm movement in three dimensions, as a series of exercises are undertaken. The equipment generates functional electrical stimulation to assist in muscle activation and thus improve directional accuracy. In addition, it monitors speed, accuracy, areas of motion weakness and similar parameters to create a performance index that can be compared over time and extrapolated to establish an independent and objective assessment scheme, plus an approximate estimation of predicted final outcome. To further extend its assessment capabilities, nerve conduction velocity readings are taken by the software, between the shoulder and hand muscles. This is utilized to measure the speed of response of neuron signal transfer along the arm and over time, an online indication of regeneration levels can be obtained. This will prove whether or not sufficient training intensity is being achieved even before perceivable movement dexterity is observed. The device also provides the option to connect to other users, via the internet, so that the patient can avoid feelings of isolation and can undertake movement exercises together with others in a similar position. This should create benefits not only for the encouragement of rehabilitation participation, but also an emotional support network potential. It is intended that this approach will extend the availability of stroke recovery options, enable ease of access at a low cost, reduce susceptibility to depression and through these endeavors, enhance the overall recovery success rate.

Keywords: home-based therapy, iterative learning control, Riener muscle model, SMART phone, stroke rehabilitation

Procedia PDF Downloads 246

Authors: Despoina Chochtoula, Aristidis Ilias, Yannis Stamatiou

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Modbus is a protocol that enables the communication among devices which are connected to the same network. This protocol is, often, deployed in connecting sensor and monitoring units to central supervisory servers in Supervisory Control and Data Acquisition, or SCADA, systems. These systems monitor critical infrastructures, such as factories, power generation stations, nuclear power reactors etc. in order to detect malfunctions and ignite alerts and corrective actions. However, due to their criticality, SCADA systems are vulnerable to attacks that range from simple eavesdropping on operation parameters, exchanged messages, and valuable infrastructure information to malicious modification of vital infrastructure data towards infliction of damage. Thus, the SCADA research community has been active over strengthening SCADA systems with suitable data protection mechanisms based, to a large extend, on cryptographic methods for data encryption, device authentication, and message integrity protection. However, due to the limited computation power of many SCADA sensor and embedded devices, the usual public key cryptographic methods are not appropriate due to their high computational requirements. As an alternative, Elliptic Curve Cryptography has been proposed, which requires smaller key sizes and, thus, less demanding cryptographic operations. Until now, however, no such implementation has been proposed in the SCADA literature, to the best of our knowledge. In order to fill this gap, our methodology was focused on integrating Modbus, a frequently used SCADA communication protocol, with Elliptic Curve based cryptography and develop a server/client application to demonstrate the proof of concept. For the implementation we deployed two C language libraries, which were suitably modify in order to be successfully integrated: libmodbus (https://github.com/stephane/libmodbus) and ecc-lib https://www.ceid.upatras.gr/webpages/faculty/zaro/software/ecc-lib/). The first library provides a C implementation of the Modbus/TCP protocol while the second one offers the functionality to develop cryptographic protocols based on Elliptic Curve Cryptography. These two libraries were combined, after suitable modifications and enhancements, in order to give a modified version of the Modbus/TCP protocol focusing on the security of the data exchanged among the devices and the supervisory servers. The mechanisms we implemented include key generation, key exchange/sharing, message authentication, data integrity check, and encryption/decryption of data. The key generation and key exchange protocols were implemented with the use of Elliptic Curve Cryptography primitives. The keys established by each device are saved in their local memory and are retained during the whole communication session and are used in encrypting and decrypting exchanged messages as well as certifying entities and the integrity of the messages. Finally, the modified library was compiled for the Android environment in order to run the server application as an Android app. The client program runs on a regular computer. The communication between these two entities is an example of the successful establishment of an Elliptic Curve Cryptography based, secure Modbus wireless communication session between a portable device acting as a supervisor station and a monitoring computer. Our first performance measurements are, also, very promising and demonstrate the feasibility of embedding Elliptic Curve Cryptography into SCADA systems, filling in a gap in the relevant scientific literature.

Keywords: elliptic curve cryptography, ICT security, modbus protocol, SCADA, TCP/IP protocol

Procedia PDF Downloads 239

Authors: Rachid Dris, Robin Treilles, Max Beaurepaire, Minh Trang Nguyen, Sam Azimi, Vincent Rocher, Johnny Gasperi, Bruno Tassin

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Microplastic sources and fluxes in urban catchments are only poorly studied. Most often, the approaches taken focus on a single source and only carry out a description of the contamination levels and type (shape, size, polymers). In order to gain an improved knowledge of microplastic inputs at urban scales, estimating and comparing various fluxes is necessary. The Laboratoire Eau, Environnement et Systèmes Urbains (LEESU), the Laboratoire Eau Environnement (LEE) and the SIAAP (Service public de l’assainissement francilien) initiated several projects to investigate different urban sources and flows of microplastics. A systemic approach is undertaken at the scale of Paris Megacity, and several compartments are considered, including atmospheric fallout, wastewater treatments plants, runoff and combined sewer overflows. These investigations are carried out within the Limnoplast and OPUR projects. Atmospheric fallout was sampled during consecutive periods ranging from 2 to 3 weeks with a stainless-steel funnel. Both wet and dry periods were considered. Different treatment steps were sampled in 2 wastewater treatment plants (Seine-Amont for activated sludge and Seine-Centre for biofiltration) of the SIAAP, including sludge samples. Microplastics were also investigated in combined sewer overflows as well as in stormwater at the outlet suburban catchment (Sucy-en-Brie, France) during four rain events. Samples are treated using hydroperoxide digestion (H₂O₂ 30 %) in order to reduce organic material. Microplastics are then extracted from the samples with a density separation step using NaI (d=1.6 g.cm⁻³). Samples are filtered on metallic filters with a porosity of 14 µm between steps to separate them from the solutions (H₂O₂ and NaI). The last filtration was carried out on alumina filters. Infrared mapping analysis (using a micro-FTIR with an MCT detector) is performed on each alumina filter. The resulting maps are analyzed using a microplastic analysis software simple, developed by Aalborg University, Denmark and Alfred Wegener Institute, Germany. Blanks were systematically carried out to consider sample contamination. This presentation aims at synthesizing the data found in the various projects. In order to carry out a systemic approach and compare the various inputs, all the data were converted into annual microplastic fluxes (number of microplastics per year), and extrapolated to the Parisian agglomeration. PP, PE and alkyd are the most prevalent polymers found in storm water samples. Rain intensity and microplastic concentrations did not show any clear correlation. Considering the runoff volumes and the impervious surface area of the studied catchment, a flux of 4*107–9*107 MPs.yr⁻¹.ha⁻¹ was estimated. Samples of wastewater treatment plants and atmospheric fallout are currently being analyzed in order to finalize this assessment. The representativeness of such samplings and uncertainties related to the extrapolations will be discussed and gaps in knowledge will be identified. The data provided by such an approach will help to prioritize future research as well as policy efforts.

Keywords: microplastics, atmosphere, wastewater, urban runoff, Paris megacity, urban waters

Procedia PDF Downloads 162

Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

Procedia PDF Downloads 159

Authors: Igor Peraza Curiel, Suzanne Strum

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Today, when many foreign architects are receiving commissions in the United Arab Emirates, it is essential to analyze how their designs are influenced by the region's culture, environment, and building traditions. This study examines the approach to siting, geometry, construction methods, and material choices in two private homes for a family in Dubai, a project being constructed on adjacent sites by the acclaimed Spanish team of RCR Architects. Their third project in Dubai, the houses mark a turning point in their design approach to the desert. The Pritzker Prize-winning architects of RCR gained renown for building works deeply responsive to the history, landscape, and customs of their hometown in a volcanic area of the Catalonia region of Spain. Key formative projects and their entry to practice in UAE will be analyzed according to the concepts of place identity, the poetics of construction, and material imagination. The poetics of construction, a theoretical position with a long practical tradition, was revived by the British critic Kenneth Frampton. The idea of architecture as a constructional craft is related to the concepts of material imagination and place identity--phenomenological concerns with the creative engagement with local matter and topography that are at the very essence of RCR's way of designing, detailing, and making. Our study situates RCR within the challenges of building in the region, where western forms and means have largely replaced the ingenious responsiveness of indigenous architecture to the climate and material scarcity. The dwellings, iterations of the same steel and concrete vaulting system, highlight the conceptual framework of RCR's design approach to offer a study in contemporary critical regionalism. The Kama House evokes Bedouin tents, while the Alwah House takes the form of desert dunes in response to the temporality of the winds. Metal mesh screens designed to capture the shifting sands will complete the forms. The original research draws on interviews with the architects and unique documentation provided by them and collected by the authors during on-site visits. By examining the two houses in-depth, this paper foregrounds a series of timely questions: 1) What is the impact of the local climatic, cultural, and material conditions on their project in the UAE? 2) How does this work further their experiences in the region? 3) How has RCR adapted their construction techniques as their work expands beyond familiar settings? The investigation seeks to understand how the design methodology developed for more than 20 years and enmeshed in the regional milieu of their hometown can transform as the architects encounter unique characteristics and values in the Middle East. By focusing on the contemporary interpretation of Arabic geometry and elements, the houses reveal the role of geometry, tectonics, and material specificity in the realization from conceptual sketches to built form. In emphasizing the importance of regional responsiveness, the dynamics of international construction practice, and detailing this study highlights essential issues for professionals and students looking to practice in an increasingly global market.

Keywords: material imagination, regional responsiveness, place identity, poetics of construction

Procedia PDF Downloads 108

Authors: A. C. Facin, M. C. Maronezi , M. P. Menezes, G. L. Montanhim, L. Pavan, M. A. R. Feliciano, R. P. Nociti, R. A. R. Uscategui, P. C. Moraes

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The incidence of brachycephalic syndrome (BS) in the clinical routine of small animals has increased significantly giving the higher proportion of brachycephalic pets in the last years and has been considered as an animal welfare problem. The treatment of BS is surgical and the clinical signs related can be considerably attenuated. Nevertheless, the systemic effects of the BS are still poorly reported and little is known about these when the surgical correction is not performed early. Affected dogs are more likely to develop cardiopulmonary, gastrointestinal and sleep disorders in which the chronic hypoxemia plays a major role. This syndrome is compared with the obstructive sleep apnea (OSA) in humans, both considered as causes of systemic and metabolic dysfunction. Among the several consequences of the BS little is known if the syndrome also affects the hepatic tissue of brachycephalic patients. Elastography is a promising ultrasound technique that evaluates tissue elasticity and has been recently used with the purpose of diagnosis of liver fibrosis. In medicine, it is a growing concern regarding the hepatic injury of patients affected by OSA. This prospective study hypothesizes if there is any consequence of BS in the hepatic parenchyma of brachycephalic dogs that don’t receive any surgical treatment. This study was conducted following the approval of the Animal Ethics and Welfare Committee of the Faculdade de Ciências Agrárias e Veterinárias, UNESP, Campus Jaboticabal, Brazil (protocol no 17944/2017) and funded by Sao Paulo Research Foundation (FAPESP, process no 2017/24809-4). The methodology was based in ARFI elastography using the ACUSON S2000/SIEMENS device, with convex multifrequential transducer and specific software as well as clinical evaluation of the syndrome, in order to determine if they can be used as a prognostic non-invasive tool. On quantitative elastography, it was collected three measures of shear wave velocity (meters per second) and depth in centimeters in the left lateral, left medial, right lateral, right medial and caudate lobe of the liver. The brachycephalic patients, 16 pugs and 30 french bulldogs, were classified using a previously established 4-point functional grading system based on clinical evaluation before and after a 3-minute exercise tolerance test already established and validated. The control group was based on the same features collected in 22 beagles. The software R version 3.3.0 was used for the analysis and the significance level was set at 0.05. The data were analysed for normality of residuals and homogeneity of variances by Shapiro-Wilks test. Comparisons of parametric continuous variables between breeds were performed by using ANOVA with a post hoc test for pair wise comparison. The preliminary results show significant statistic differences between the brachycephalic groups and the control group in all lobes analysed (p ≤ 0,05), with higher values of shear wave velocities in the hepatic tissue of brachycephalic dogs. In this context, the results obtained in this study contributes to the understanding of BS as well as its consequences in our patients, reflecting in evidence that one more systemic consequence of the syndrome may occur in brachycephalic patients, which was not related in the veterinary literature yet.

Keywords: airway obstruction, brachycephalic airway obstructive syndrome, hepatic injury, obstructive sleep apnea

Procedia PDF Downloads 106

Authors: A. Kolendo

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Pacific Islands are one of the most vulnerable areas to climate change. Sea level rise and accelerating storm surge continuously threaten the communities' habitats on low-lying atolls. With scientific predictions of encroaching tides on their land, the Islanders have been informed about the need for future relocation planning. However, some communities oppose such retreat strategies through the reasoning that comprehends current climatic changes through the lenses of the biblical ark of Noah. This parable states God's promise never to flood the Earth again and never deprive people of their land and habitats. Several interpretations of this parable emerged in Oceania, prompting either climate action or denial. Resistance to relocation planning expressed through Christian thoughts led religion to be perceived as a barrier to dialogue between the Islanders and scientists. Since climate change concerns natural processes, the attitudes towards environmental stewardship prompt the communities' responses to it; some Christian teachings indicate humanity's responsibility over the environment, whereas others ascertain the people's dominion, which prompts resistance and sometimes denial. With church denominations and their various environmental standpoints, competing responses to climate change emerged in Oceania. Before miss-ionization, traditional knowledge had guided the environmental sphere, influencing current Christian teachings. Each atoll characterizes a distinctive manner of traditional knowledge; however, the unique relationship with nature unites all islands. The interconnectedness between the land, sea and people indicates the integrity between the communities and their environments. Such a factor influences the comprehension of Noah's story in the context of climate change that threatens their habitats. Pacific Islanders experience climate change through the slow disappearance of their homelands. However, the Western world perceives it as a global issue that will affect the population in the long-term perspective. Therefore, the Islanders seek to comprehend this global phenomenon in a local context that reads climate change as the Great Deluge. Accordingly, the safety measures that this parable promotes compensate for the danger of climate change. The rainbow covenant gives hope in God's promise never to flood the Earth again. At the same time, Noah's survival relates to the Islanders' current situation. Since these communities have the lowest carbon emissions rate, their contribution to anthropogenic climate change is scarce. Therefore, the lack of environmental sin would contextualize them as contemporary Noah with the ultimate survival of sea level rise. This study aims to defy religion constituting a barrier through secondary data analysis from a risk compensation perspective. Instead, religion is portrayed as a source of knowledge that enables comprehension of the communities' situation. By demonstrating that the Pacific Islanders utilize Noah's story as a vessel for coping with the danger of climate change, the study argues that religion provides safety measures that compensate for the future projections of land's disappearance. The purpose is to build a bridge between religious communities and scientific bodies and ultimately bring an understanding of two diverse perspectives. By addressing the practical challenges of interdisciplinary research with faith-based systems, this study uplifts the voices of communities and portrays their experiences expressed through Christian thoughts.

Keywords: Christianity, climate change, existential threat, Pacific Islands, story of Noah

Procedia PDF Downloads 67

Authors: Zeyu Zhou, Ziyu Zhao, Xiaochen Yang, Ling AI, Heng Zhai, Stuart Holmes

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As a promising sustainable alternative to traditional fossil fuels, fuel cell technology is highly favoured due to its enhanced working efficiency and reduced emissions. In the context of high-temperature fuel cells (operating above 100 °C), the most commonly used proton exchange membrane (PEM) is the Polybenzimidazole (PBI) doped phosphoric acid (PA) membrane. Grafting is a promising strategy to advance PA-doped PBI PEM technology. The existing grafting modification on PBI PEMs mainly focuses on grafting phosphate-containing or alkaline groups onto the PBI molecular chains. However, quaternary ammonium-based grafting approaches face a common challenge. To initiate the N-alkylation reaction, deacidifying agents such as NaH, NaOH, KOH, K2CO3, etc., can lead to ionic crosslinking between the quaternary ammonium group and PBI. Polyvinylpyrrolidone (PVP) is another widely used polymer, the N-heterocycle groups within PVP endow it with a significant ability to absorb PA. Recently, PVP has attracted substantial attention in the field of fuel cells due to its reduced environmental impact and impressive fuel cell performance. However, due to the the poor compatibility of PVP in PBI, few research apply PVP in PA-doped PBI PEMs. This work introduces an innovative strategy to graft PVP onto PBI to form a network-like polymer. Due to the absence of quaternary ammonium groups, PVP does not pose issues related to crosslinking with PBI. Moreover, the nitrogen-containing functional groups on PVP provide PBI with a robust phosphoric acid retention ability. The nuclear magnetic resonance (NMR) hydrogen spectrum analysis results indicate the successful completion of the grafting reaction where N-alkylation reactions happen on both sides of the grafting agent 1,4-bis(chloromethyl)benzene. On one side, the reaction takes place with the hydrogen atoms on the imidazole groups of PBI, while on the other side, it reacts with the terminal amino group of PVP. The XPS results provide additional evidence from the perspective of the element. On synthesized PBI-g-PVP surfaces, there is an absence of chlorine (chlorine in grafting agent 1,4-bis(chloromethyl)benzene is substituted) element but a presence of sulfur element (sulfur element in terminal amino PVP appears in PBI), which demonstrates the occurrence of the grafting reaction and PVP is successfully grafted onto PBI. Prepare these modified membranes into MEA. It was found that during the fuel cell operation, all the grafted membranes showed substantial improvement in maximum current density and peak power density compared to unmodified one. For PBI-g-PVP 30, with a grafting degree of 22.4%, the peak power density reaches 1312 mW cm⁻², marking a 59.6% enhancement compared to the pristine PBI membrane. The improvement is caused by the improved PA binding ability of the membrane after grafting. The AST test result shows that the grafting membranes have better long-term durability and performance than unmodified membranes attributed to the presence of added PA binding sites, which can effectively prevent the PA leaching caused by proton migration. In conclusion, the test results indicate that grafting PVP onto PBI is a promising strategy which can effectively improve the fuel cell performance.

Keywords: fuel cell, grafting modification, PA doping ability, PVP

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Authors: Michal Kielbik, Izabela Szulc-Kielbik, Anna Brzostek, Jaroslaw Dziadek, Magdalena Klink

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The goal of many research groups in the world is to find new components that are important for survival of mycobacteria in the host cells. Mycobacterium tuberculosis (Mtb) possesses a number of enzymes degrading cholesterol that are considered to be an important factor for its survival and persistence in host macrophages. One of them - cholesterol oxidase (ChoD), although not being essential for cholesterol degradation, is discussed as a virulence compound, however its involvement in macrophages’ response to Mtb is still not sufficiently determined. The recognition of tubercle bacilli antigens by pathogen recognition receptors is crucial for the initiation of the host innate immune response. An important receptor that has been implicated in the recognition and/or uptake of Mtb is Toll-like receptor type 2 (TLR2). Engagement of TLR2 results in the activation and phosphorylation of intracellular signaling proteins including IRAK-1 and -4, TRAF-6, which in turn leads to the activation of target kinases and transcription factors responsible for bactericidal and pro-inflammatory response of macrophages. The aim of these studies was a detailed clarification of the role of Mtb cholesterol oxidase as a virulence factor affecting the TLR2 signaling pathway in human macrophages. As human macrophages the THP-1 differentiated cells were applied. The virulent wild-type Mtb strain (H37Rv), its mutant lacking a functional copy of gene encoding cholesterol oxidase (∆choD), as well as complimented strain (∆choD–choD) were used. We tested the impact of Mtb strains on the expression of TLR2-depended signaling proteins (mRNA level, cytosolic level and phosphorylation status). The cytokine and bactericidal response of THP-1 derived macrophages infected with Mtb strains in relation to TLR2 signaling pathway dependence was also determined. We found that during the 24-hours of infection process the wild-type and complemented Mtb significantly reduced the cytosolic level and phosphorylation status of IRAK-4 and TRAF-6 proteins in macrophages, that was not observed in the case of ΔchoD mutant. Decreasement of TLR2-dependent signaling proteins, induced by wild-type Mtb, was not dependent on the activity of proteasome. Blocking of TLR2 expression, before infection, effectively prevented the induced by wild-type strain reduction of cytosolic level and phosphorylation of IRAK-4. None of the strains affected the surface expression of TLR2. The mRNA level of IRAK-4 and TRAF-6 genes were significantly increased in macrophages 24 hours post-infection with either of tested strains. However, the impact of wild-type Mtb strain on both examined genes was significantly stronger than its ΔchoD mutant. We also found that wild-type strain stimulated macrophages to release high amount of immunosuppressive IL-10, accompanied by low amount of pro-inflammatory IL-8 and bactericidal nitric oxide in comparison to mutant lacking cholesterol oxidase. The influence of wild-type Mtb on this type of macrophages' response strongly dependent on fully active IRAK-1 and IRAK-4 signaling proteins. In conclusion, Mtb using cholesterol oxidase causes the over-activation of TLR2 signaling proteins leading to the reduction of their cytosolic level and activity resulting in the modulation of macrophages response to allow its intracellular survival. Supported by grant: 2014/15/B/NZ6/01565, National Science Center, Poland

Keywords: Mycobacterium tuberculosis, cholesterol oxidase, macrophages, TLR2-dependent signaling pathway

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Authors: M. Mueller, M. Kuehn, M. Voelker

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In small and medium-sized enterprises (SMEs), the challenge is to create a well-grounded and reliable basis for process analysis, optimization and planning due to a lack of data. SMEs have limited access to methods with which they can effectively and efficiently analyse processes and identify cause-and-effect relationships in order to generate the necessary database and derive optimization potential from it. The implementation of digitalization within the framework of Industry 4.0 thus becomes a particular necessity for SMEs. For these reasons, the abstract presents an analysis methodology that is subject to the objective of developing an SME-appropriate methodology for efficient, temporarily feasible data collection and evaluation in flexible production and logistics systems as a basis for process analysis and optimization. The overall methodology focuses on retrospective, event-based tracing and analysis of material flow objects. The technological basis consists of Bluetooth low energy (BLE)-based transmitters, so-called beacons, and smart mobile devices (SMD), e.g. smartphones as receivers, between which distance data can be measured and derived motion profiles. The distance is determined using the Received Signal Strength Indicator (RSSI), which is a measure of signal field strength between transmitter and receiver. The focus is the development of a software-based methodology for interpretation of relative movements of transmitters and receivers based on distance data. The main research is on selection and implementation of pattern recognition methods for automatic process recognition as well as methods for the visualization of relative distance data. Due to an existing categorization of the database regarding process types, classification methods (e.g. Support Vector Machine) from the field of supervised learning are used. The necessary data quality requires selection of suitable methods as well as filters for smoothing occurring signal variations of the RSSI, the integration of methods for determination of correction factors depending on possible signal interference sources (columns, pallets) as well as the configuration of the used technology. The parameter settings on which respective algorithms are based have a further significant influence on result quality of the classification methods, correction models and methods for visualizing the position profiles used. The accuracy of classification algorithms can be improved up to 30% by selected parameter variation; this has already been proven in studies. Similar potentials can be observed with parameter variation of methods and filters for signal smoothing. Thus, there is increased interest in obtaining detailed results on the influence of parameter and factor combinations on data quality in this area. The overall methodology is realized with a modular software architecture consisting of independently modules for data acquisition, data preparation and data storage. The demonstrator for initialization and data acquisition is available as mobile Java-based application. The data preparation, including methods for signal smoothing, are Python-based with the possibility to vary parameter settings and to store them in the database (SQLite). The evaluation is divided into two separate software modules with database connection: the achievement of an automated assignment of defined process classes to distance data using selected classification algorithms and the visualization as well as reporting in terms of a graphical user interface (GUI).

Keywords: event-based tracing, machine learning, process classification, parameter settings, RSSI, signal smoothing

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Authors: Marcelo Pereira Introini

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The global value chains (GVC) approach contributes to a better understanding of the international production organization amid globalization’s second unbundling from the 1970s on. Mainly due to the tools that help to understand the importance of critical competences, technological capabilities, and functions performed by each player, GVC research flourished in recent years, rooted in discussing the possibilities of integration and repositioning along regional and global value chains. Regarding this context, part of the literature endorsed a more optimistic view that engaging in fragmented production networks could represent learning opportunities for developing countries’ firms, since the relationship with transnational corporations could allow them build skills and competences. Increasing recognition that GVCs are based on asymmetric power relations provided another sight about benefits, costs, and development possibilities though. Once leading companies tend to restrict the replication of their technologies and capabilities by their suppliers, alternative strategies beyond the functional specialization, seen as a way to integrate value chains, began to be broadly highlighted. This paper organizes a coherent narrative about the shortcomings of the GVC analytical framework, while recognizing its multidimensional contributions and recent developments. We adopt two different and complementary perspectives to explore the idea of integration in the international production. On one hand, we emphasize obstacles beyond production components, analyzing the role played by intangible assets and intellectual property regimes. On the other hand, we consider the importance of domestic production and innovation systems for technological development. In order to provide a deeper understanding of the restrictions on technological learning of developing countries’ firms, we firstly build from the notion of intellectual monopoly to analyze how flagship companies can prevent subordinated firms from improving their positions in fragmented production networks. Based on intellectual property protection regimes we discuss the increasing asymmetries between these players and the decreasing access of part of them to strategic intangible assets. Second, we debate the role of productive-technological ecosystems and of interactive and systemic technological development processes, as concepts of the Innovation Systems approach. Supporting the idea that not only endogenous advantages are important for international competition of developing countries’ firms, but also that the building of these advantages itself can be a source of technological learning, we focus on local efforts as a crucial element, which is not replaceable for technology imported from abroad. Finally, the paper contributes to the discussion about technological development as a two-dimensional dynamic. If GVC analysis tends to underline a company-based perspective, stressing the learning opportunities associated to GVC integration, historical involvement of national States brings up the debate about technology as a central aspect of interstate disputes. In this sense, technology is seen as part of military modernization before being also used in civil contexts, what presupposes its role for national security and productive autonomy strategies. From this outlook, it is important to consider it as an asset that, incorporated in sophisticated machinery, can be the target of state policies besides the protection provided by intellectual property regimes, such as in export controls and inward-investment restrictions.

Keywords: global value chains, innovation systems, intellectual monopoly, technological development

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Authors: Joseph M. Rich, Vinay A. Duddalwar, Assad A. Oberai

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Prostate adenocarcinoma is the most common cancer in males, with osseous metastases as the commonest site of metastatic prostate carcinoma (mPC). Treatment monitoring is based on the evaluation and characterization of lesions on multiple imaging studies, including Computed Tomography (CT). Monitoring of the osseous disease burden, including follow-up of lesions and identification and characterization of new lesions, is a laborious task for radiologists. Deep learning algorithms are increasingly used to perform tasks such as identification and segmentation for osseous metastatic disease and provide accurate information regarding metastatic burden. Here, nnUNet was used to produce a model which can segment CT scan images of prostate adenocarcinoma vertebral bone metastatic lesions. nnUNet is an open-source Python package that adds optimizations to deep learning-based UNet architecture but has not been extensively combined with transfer learning techniques due to the absence of a readily available functionality of this method. The IRB-approved study data set includes imaging studies from patients with mPC who were enrolled in clinical trials at the University of Southern California (USC) Health Science Campus and Los Angeles County (LAC)/USC medical center. Manual segmentation of metastatic lesions was completed by an expert radiologist Dr. Vinay Duddalwar (20+ years in radiology and oncologic imaging), to serve as ground truths for the automated segmentation. Despite nnUNet’s success on some medical segmentation tasks, it only produced an average Dice Similarity Coefficient (DSC) of 0.31 on the USC dataset. DSC results fell in a bimodal distribution, with most scores falling either over 0.66 (reasonably accurate) or at 0 (no lesion detected). Applying more aggressive data augmentation techniques dropped the DSC to 0.15, and reducing the number of epochs reduced the DSC to below 0.1. Datasets have been identified for transfer learning, which involve balancing between size and similarity of the dataset. Identified datasets include the Pancreas data from the Medical Segmentation Decathlon, Pelvic Reference Data, and CT volumes with multiple organ segmentations (CT-ORG). Some of the challenges of producing an accurate model from the USC dataset include small dataset size (115 images), 2D data (as nnUNet generally performs better on 3D data), and the limited amount of public data capturing annotated CT images of bone lesions. Optimizations and improvements will be made by applying transfer learning and generative methods, including incorporating generative adversarial networks and diffusion models in order to augment the dataset. Performance with different libraries, including MONAI and custom architectures with Pytorch, will be compared. In the future, molecular correlations will be tracked with radiologic features for the purpose of multimodal composite biomarker identification. Once validated, these models will be incorporated into evaluation workflows to optimize radiologist evaluation. Our work demonstrates the challenges of applying automated image segmentation to small medical datasets and lays a foundation for techniques to improve performance. As machine learning models become increasingly incorporated into the workflow of radiologists, these findings will help improve the speed and accuracy of vertebral metastatic lesions detection.

Keywords: deep learning, image segmentation, medicine, nnUNet, prostate carcinoma, radiomics

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Authors: Michael Sonne Kristensen, Frank Loesche, James Foster, Elif Ozcan, Judy Edworthy

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Auditory alarms play an integral role in intensive care nurses’ daily work. Most medical devices in the intensive care unit (ICU) are designed to produce alarm sounds in order to make nurses aware of immediate or prospective safety risks. The utilisation of sound as a carrier of crucial patient information is highly dependent on nurses’ presence - both physically and mentally. For ICU nurses, especially the ones who work with stationary alarm devices at the patient bed space, it is a challenge to display ‘appropriate’ alarm responses at all times as they have to navigate with great flexibility in a complex work environment. While being primarily responsible for a small number of allocated patients they are often required to engage with other nurses’ patients, relatives, and colleagues at different locations inside and outside the unit. This work explores the social strategies used by a team of nurses to comprehend and react to the information conveyed by the alarms in the ICU. Two main research questions guide the study: To what extent do alarms from a patient bed space reach the relevant responsible nurse by direct auditory exposure? By which means do responsible nurses get informed about their patients’ alarms when not directly exposed to the alarms? A comprehensive video-ethnographic field study was carried out to capture and evaluate alarm-related events in an ICU. The study involved close collaboration with four nurses who wore eye-level cameras and ear-level binaural audio recorders during several work shifts. At all time the entire unit was monitored by multiple video and audio recorders. From a data set of hundreds of hours of recorded material information about the nurses’ location, social interaction, and alarm exposure at any point in time was coded in a multi-channel replay-interface. The data shows that responsible nurses’ direct exposure and awareness of the alarms of their allocated patients vary significantly depending on work load, social relationships, and the location of the patient’s bed space. Distributed listening is deliberately employed by the nursing team as a social strategy to respond adequately to alarms, but the patterns of information flow prompted by alarm-related events are not uniform. Auditory Spatiotemporal Trajectory (AST) is proposed as a methodological label to designate the integration of temporal, spatial and auditory load information. As a mixed-method metrics it provides tangible evidence of how nurses’ individual alarm-related experiences differ from one another and from stationary points in the ICU. Furthermore, it is used to demonstrate how alarm-related information reaches the individual nurse through principles of social and distributed cognition, and how that information relates to the actual alarm event. Thereby it bridges a long-standing gap in the literature on medical alarm utilisation between, on the one hand, initiatives to measure objective data of the medical sound environment without consideration for any human experience, and, on the other hand, initiatives to study subjective experiences of the medical sound environment without detailed evidence of the objective characteristics of the environment.

Keywords: auditory spatiotemporal trajectory, medical alarms, social cognition, video-ethography

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Authors: Sudeshna Chandra, Christian Gäbler, Christian Schliebe, Heinrich Lang

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Highly branched dendrimers provide structural homogeneity, controlled composition, comparable size to biomolecules, internal porosity and multiple functional groups for conjugating reactions. Electro-active dendrimers containing multiple redox units have generated great interest in their use as electrode modifiers for development of biosensors. The electron transfer between the redox-active dendrimers and the biomolecules play a key role in developing a biosensor. Ferrocenes have multiple and electrochemically equivalent redox units that can act as electron “pool” in a system. The ferrocenyl-terminated polyamidoamine dendrimer is capable of transferring multiple numbers of electrons under the same applied potential. Therefore, they can be used for dual purposes: one in building a film over the electrode for immunosensors and the other for immobilizing biomolecules for sensing. Electrochemical immunosensor, thus developed, exhibit fast and sensitive analysis, inexpensive and involve no prior sample pre-treatment. Electrochemical amperometric immunosensors are even more promising because they can achieve a very low detection limit with high sensitivity. Detection of the cancer biomarkers at an early stage can provide crucial information for foundational research of life science, clinical diagnosis and prevention of disease. Elevated concentration of biomarkers in body fluid is an early indication of some type of cancerous disease and among all the biomarkers, IgG is the most common and extensively used clinical cancer biomarkers. We present an IgG (=immunoglobulin) electrochemical immunosensor using a newly synthesized redox-active ferrocenyl dendrimer of generation 2 (G2Fc) as glassy carbon electrode material for immobilizing the antibody. The electrochemical performance of the modified electrodes was assessed in both aqueous and non-aqueous media using varying scan rates to elucidate the reaction mechanism. The potential shift was found to be higher in an aqueous electrolyte due to presence of more H-bond which reduced the electrostatic attraction within the amido groups of the dendrimers. The cyclic voltammetric studies of the G2Fc-modified GCE in 0.1 M PBS solution of pH 7.2 showed a pair of well-defined redox peaks. The peak current decreased significantly with the immobilization of the anti-goat IgG. After the immunosensor is blocked with BSA, a further decrease in the peak current was observed due to the attachment of the protein BSA to the immunosensor. A significant decrease in the current signal of the BSA/anti-IgG/G2Fc/GCE was observed upon immobilizing IgG which may be due to the formation of immune-conjugates that blocks the tunneling of mass and electron transfer. The current signal was found to be directly related to the amount of IgG captured on the electrode surface. With increase in the concentration of IgG, there is a formation of an increasing amount of immune-conjugates that decreased the peak current. The incubation time and concentration of the antibody was optimized for better analytical performance of the immunosensor. The developed amperometric immunosensor is sensitive to IgG concentration as low as 2 ng/mL. Tailoring of redox-active dendrimers provides enhanced electroactivity to the system and enlarges the sensor surface for binding the antibodies. It may be assumed that both electron transfer and diffusion contribute to the signal transformation between the dendrimers and the antibody.

Keywords: ferrocenyl dendrimers, electrochemical immunosensors, immunoglobulin, amperometry

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